asked the Minister for Health if he is aware of a report prepared for the Eastern Health Board by Dr. Brendan Pigott, the board's chief dental officer, which showed that in the Dublin area the ratio of dentists in the public service to people entitled to public care was 1:2,900, whereas the desired ratio was 1:1,500; the measures he is taking to provide additional dentists in the Dublin area; and if he will make a statement on the matter.

2.

asked the Minister for Health if, in view of the serious shortage of dentists in the public health service in the Eastern Health Board area, the Government will exclude dentists from the embargo on recruitment to the public service.

3.

asked the Minister for Health if he intends to establish more dental positions with the Eastern Health Board, with particular reference to the Dublin area.

I propose to take Questions Nos. 1, 2 and 3 together. I am aware of Dr. Pigott's report.

On the basis of figures available to me the Dublin area and the Eastern Health Board area generally have a very favourable ratio of public dental officers to eligible children when compared with other health board areas. The desired ratio of one dentist to every 1,500 eligible children quoted in the report would represent an ideal situation in which there were no restraints on spending or recruitment. No additional posts can be created in the health services area at present due to the general embargo on the creation of additional posts in the public sector. I do not consider that the dentist/patient ratio in the Eastern Health Board area justifies an approach by me to my colleagues in Government to exclude dentists from the embargo on recruitment to the public services.

As the Minister is aware of the Pigott report he will be aware that, as it states, the waiting time is four months in some parts of the Eastern Health Board area for routine dental care and that in excess of 7,000, possibly 8,000, people between the elderly and students are on a waiting list for routine dental care. Does he not consider that this calls for a re-examination of the embargo on the appointment of dentists in the EHB area?

In the Dublin area alone there are 144,000 eligible school children in the EHB area. Taking in the other counties there are 180,000 in all. In Dublin there are 66 public dental officers. That is a ratio of 1:2,180 and it is the second best ratio in the country. The Southern Health Board have 2,128. There is a waiting list, but, as I indicated to the Deputy previously, the waiting time in May 1983 was between two weeks and three months in the EHB area.

The Pigott report indicates that in a greater emphasis on a preventive programme a ratio of 1:1,200 eligible persons would suffice. Have the Department of Health or the Minister embarked on any kind of increased preventive programme or is the Minister disposed to pursue such a programme?

One factor which adds to the relatively favourable position in Dublin is that while the ad hoc scheme under which adults are treated by private practitioners has been curtailed in some health board areas, it has not been so to any great extent in the EHB area. As a result, where the scheme has been curtailed adults are depending on public dental officers for treatment, but the situation in the EHB is not too bad. Undoubtedly I would like to see it improved, but one must remember that there are 66 public dental officers in Dublin and 75 in the EHB in all. That compares with ten for the midlands. In the north-western area there are only 11 public dental officers, that is one for every 3,000 people and in Dublin it is one for every 2,000 people.

Is the Minister satisfied that the Eastern Health Board are fulfilling their statutory obligation to provide a proper and adequate dental service?

They are doing their utmost within the limitation of the number of public dental officers available to the board. Ideally one would wish to see one dental officer for every 1,500 people but that would entail an enormous increase in general expenditure.

Does the Minister accept that it is now time for the embargo, which has been in operation for almost four years, to be reviewed and to have dental officers excluded from it?

I have always held the view that in this area the operation of the embargo is a rather crude and blunt instrument. My colleagues in Government are aware of my views in the matter but that is the way the embargo was brought in originally.

I asked if a preventive programme was being pursued by the Department. Is the Minister aware that the report indicated that, due to shortage of staff, it was not possible to carry out school examinations in all areas? Does the Minister agree that this is an important part of any preventive programme and that it indicates the need for the appointment of more dentists, especially in the Eastern Health Board area?

When resources become available, or if current resources become available they should go into such a programme for school children and young adolescents. Undoubtedly that is the area of greatest need. The working party report on dental care and services strongly recommended that and I am in favour of it. However, until such time as we get more resources we will have to make do with the position as it is but I agree that prevention is worth a lot more than subsequent cure.

4.